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Chiropractic Networks Action Center
ACA has created the Chiropractic Networks Action Center to provide an area where providers and patients can make their concerns heard. It is also the place where providers can access helpful resources, read about ACA's efforts to combat inappropriate network practices, address the concerns of the chiropractic profession regarding chiropractic managed care networks, and speak up on behalf of doctors of chiropractic.
In the News
BREAKING NEWS: Court Rules in Favor of Class Standing in United Healthcare/Optum Lawsuit (9/2/2014)
In a long-awaited victory for the chiropractic profession and case led by the American Chiropractic Association, a very favorable decision was issued by the Court in the pending action against UnitedHealthcare/Optum. The Court granted class standing which not only allows plaintiffs who are not within United’s network of providers to seek relief on a class-wide basis, but endorses the applicability of ERISA’s regulations to UHC/Optum’s requests for repayment. ACA requests all providers affected by UHC/Optum’s practices to contact us immediately. For more detailed information on this landmark step, please click here.
For questions or further information, please contact firstname.lastname@example.org. (To learn more about the issues that led to ACA's involvement in the UHC/Optum case see the timeline below under "ACA Joins Lawsuit Against UHC and OptumHealth." To view the actual above-mentioned order granting class certification click here.)
ACA Joins Lawsuit Against UHC and OptumHealth
- December 2013 Update: A New Jersey federal judge has ruled that a doctor of chiropractic may pursue his overpayment allegations against UnitedHealthcare even though his patients are no longer insured by the company. The ruling says patients are still subject to the health insurer's overpayment recoupment procedures. To read more see ACA's Press Release here.
- April 2012 Update: ACA and co-plaintiffs successfully defeated UnitedHealthcare and OptumHealth’s motion to dismiss, which now allows the profession to pursue alleged ERISA violations. The decision by the U.S. District Court for the District of New Jersey upheld the viability of the plaintiffs’ central, underlying claims against United and its co-defendants, including the inappropriate recoupment of reimbursements previously paid to providers. The defeat of the defendant’s motion to dismiss now allows plaintiffs to pursue injunctive relief for the inappropriate and abusive practices long fought by the chiropractic profession, which have restricted patient care and, the profession believes, harmed the careers of doctors of chiropractic. To view details see ACA’s Press Release here.
- On January 24, 2011, litigation was filed that represents a nationwide class of health care providers who were subjected to improper audits and recoupment demands by United Healthcare in a violation of the Employee Retirement Income Security Act of 1974 (ERISA). On April 22, 2011, ACA amended the original complaint alleging that United, through its chiropractic network, OptumHealth, adopted a series of internal policies and procedures intended to improperly deny benefits. See ACA’s Press Release here. See complaint filed against United Healthcare and OptumHealth here.
- ACA Aggressively Pursues Concerns with ASHN--Based on concerns received from many states across the nation, American Specialty Health Network (ASHN) has created chaos for providers and patients by not thoroughly vetting its business arrangements through state Departments of Insurance and by implementing egregious practices that restrict patient care. The overall confusion from these practices has caused patients, providers and employers to become very concerned.
- Efforts by ACA and Kentucky Association of Chiropractors Bring Action Against Humana - Following an investigation of the activities of Humana, the Kentucky Department of Insurance (DOI) identified numerous deficiencies and violations in the insurer’s business practices. Humana was fined $100,000 and is required by the order to take corrective action.
Follow these simple steps:
- To send ACA supporting documentation click here to download a fax cover sheet and authorization forms that must accompany your information.
- To alert your State’s Department of Insurance click here for easy to follow instructions.
- To advocate for any patient covered by an employer-sponsored plan, click here to access ACA’s ERISA resources and a step-by-step checklist.
Commentary from Other Organizations
- Parker Chiropractic College
- New York Chiropractic College
- Texas Board of Chiropractic Examiners
- Florida Department of Health
- Kentucky Department of Insurance
- Ohio State Chiropractic Board
- Federation of Chiropractic Licensing Boards
- Nebraska State Board of Chiropractic
- Arkansas State Board of Chiropractic Examiners
ACA has long been a proponent of fair utilization review and the right of the patient to access their insurance benefits without inappropriately restrictive policies of insurers, networks and managed care organizations. ACA‘s House of Delegates passed an important resolution you should know about. It states, in part:
“Resolved, that ACA opposes any limitations by public and private insurers including managed care networks, as it relates to chiropractic coverage, benefits, and reimbursement that negatively impact the clinical decision making process and the quality of care proposed or administered to a chiropractic patient. These limitations may include, but are not limited to...actions taken by payers, their agents, employees, consultants, or business partners, to intimidate, dissuade or present a financial hardship for either the patient in obtaining, or the provider in rendering quality care.”
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